J Coll Physicians Surg Pak. 2025 Dec;35(12):1521-1525. doi: 10.29271/jcpsp.2025.12.1521.
ABSTRACT
OBJECTIVE: To compare distal transradial access (dTRA) via the anatomical snuffbox as an alternative to conventional transradial access (TRA) for coronary angiography and angioplasty in terms of clinical outcomes and feasibility.
STUDY DESIGN: An observational study. Place and Duration of the Study: Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan, from August 2022 to January 2023.
METHODOLOGY: This study analysed medical records involving 100 participants, through a convenience sampling, who underwent angio- graphy, with or without angioplasty, during the years 2022-2023. The participants were divided into two groups: Fifty patients were randomly selected for the conventional TRA group (Group T) and 50 for the dTRA group (Group D). Both groups were compared based on procedure type and the target vessel for angioplasty to minimise bias. Stratification analysis was performed using the independent t-test or Mann-Whitney U test (two-tailed) for quantitative data, and the Chi-square or Fisher's exact test for qualitative data to compare the groups based on their clinical and demographic profiles, procedural characteristics, and follow-up data, including post-procedural complications.
RESULTS: The mean age of participants was comparable between Group D (58.6 ± 9.26 years) and Group T (57.8 ± 9.80 years). Procedural parameters, including median procedure time (Group D: 25 minutes; Group T: 25 minutes) and median fluoroscopy time (Group D: 6.40 minutes; Group T: 4.90 minutes), showed no significant differences (p >0.05). Group D had a higher proportion of procedures for acute coronary syndrome (ACS) (56.0% vs. 34.0%; p = 0.044); however, no differences were observed for other indications. Haematoma incidence (Group D 2.0% vs. Group T 12%; p = 0.004) and haemostasis time (Group D vs. Group T) were significantly lower in Group D.
CONCLUSION: dTRA demonstrated comparable procedural efficiency to conventional TRA while offering significant advantages in safety and post-procedural outcomes. The faster haemostasis and reduced incidence of complications, particularly haematoma formation, suggest that dTRA may provide a safer vascular access alternative, minimising patient discomfort and enhancing recovery. Key Words: Transradial access, Distal radial artery access, Snuffbox, Coronary angiography, Coronary angioplasty.
PMID:41351084 | DOI:10.29271/jcpsp.2025.12.1521